We would like to congratulate Dipes Mandal for winning an individual achievement award for his work with the Stroke Association of Bengal.
What inspires
you to advocate for stroke education?
The helpless and
hapless condition of millions of stroke
afflicted people, most of whom could
have been prevented is the most important factor which ignited me to work in the
most easy way to save them from physical and economic devastation. As India, with a population of about 1.3billion with an annual stroke incidence being about 2 million, the most important way to save
them is stroke prevention through Stroke Awareness and Stroke Education, which
was not properly looked into till few
years back. This is more important where the infrastructure for stroke care
service is very insufficient, more so in rural areas, where two thirds of
Indians reside.
What does stroke
care look like in your country?
Stroke care
service is most neglected among the leading devastating disorders in India and
needs immediate attention of all stake
holders. India is a vast country with
people of many faiths and cultural divides. The divide between the urban and
rural is also big. Health care facilities are not equally available to all.
Ideal stroke care is available only in a few big cities – in few tertiary centres and only shows the the tip of
the ice berg in stroke care service for those who can afford care in private
hospitals. In India about
2million people are afflicted annually of which over 6 lakh die and many more
are disabled after immediate crisis. Stroke is on the rise in developing
countries where lifestyle diseases are becoming an epidemic due rapid urbanization and fast life. However
stroke occurs equally in the rural areas
where food types, salt intake, tobacco
addictions (smoking and chewing) add to
the undiagnosed hypertension and diabetes.
>85% strokes occur in developing countries like India which lack
infrastructure and finances to tackle the malady. In India the alarming fact is
that stroke strikes people about 15
years earlier than those in the
Western world. This means it affects the people in the most productive years of
life. If the main bread winner, usually
the male here, is affected the family suffers enormously. In eastern
India, there is high incidence of
hemorrhagic stroke in contrast to the western world. In our place, it has been
observed that people in the 40s and 50s
have high incidence of hemorrhagic strokes. Uncontrolled/undiagnosed high blood
pressure ( hypertension) is the commonest cause of all strokes especially
hemorrhagic strokes. Proper data is lacking in India. What is a fact is that
>70% people live in rural India and lack uniformity and accessibility to
even basic health care facilities. The cost of stroke management is quite high
in terms of acute management and also in subsequent post stroke follow-up. there is no dedicated
Stroke Institute existing in West Bengal which may cater all aspects of management to a large
number of stroke patients and stroke-prone individuals – Rural & Urban, the
Rich and the Poor irrespective of age, gender, race, religion and
region.
What element
of stroke care are you most proud of?
That stroke is
by and large preventable in > 85% cases has
to be ingrained in all stroke care facilities and programs. In India
most people stop their blood pressure medications and chew tobacco or smoke. With our
continuous campaign we have been able to make people realize ill effects of
these addiction on the high incidence of stroke and heart attack. The
importance of proper rehabilitation
and required medication have been
established among most of the cases and the caregivers. Moreover, there has
been rapid awareness about recognition of stroke and its early hospital management.
What have been the highs so far?
Very rapid spread of Awareness
among the general public about the term “Stroke” which means Brain Attack , and
not Heart Attack through intensive
uninterrupted stroke awareness is a very important development in Stroke Awareness and its management. People now realize the importance of acute stroke management in a
stroke centre. Importance of rehabilitation is also gaining grounds, even in
rural areas.
Stroke Foundation of Bengal (SFB),
the only non-profit registered organization in India and a member of World
Stroke Organization (WSO) is committed to fight stroke malady in our country
with minimal resources and aids, in the guidelines adopted by World Stroke
Organization. As stroke is very much a preventable disease and is better
prevented (esp. By controlling high blood pressure and stopping tobacco
addiction) than treated, our Stroke
Foundation started its stroke prevention campaign since its inception in 2006. Before the inception of stroke Foundation, the
different programs on stroke awareness was started in the Mdedical College, Kolkata since 2000. Along
with awareness, a study was conducted in 2003, to assess the level of
awareness of stroke among the general people, which revealed about 65% of
participant considered Stroke as Heart
attack. Following awareness programs, there are significant rise in stroke
information in all section of the
society.
The standard
conventional modalities of stroke education
include seminars, meetings,
leaflets distribution, articles in papers, magazines, Bulletins, Stroke Documentary (with English
subtitles) souvenir, etc., and also the publication of quarterly stroke bulletin in
both Bengali and English. The more recent modalities include regularly updated
website (www.strokefoundationbengal.org),
Facebook etc. We have received enough helps from print and
electronic media in stroke awareness campaign .Stroke Foundation is also
taking care of rehabilitation program of
the post-stroke disabled patients and also has formed Stroke Support Group (the
second in India) for overall benefits of the stroke victims and their family
members. The introduction of Stroke
awareness about its risk factors
and future predictability through smartphone by installing Stroke Riskometer app is the latest and most innovative tool in
stroke care. All these works are moving slowly but steadily, and
that is really very high in a vast country with so much population with
significant lack of awareness.
The activities
of the Stroke Foundation are appreciated by the leaders of the World Stroke
Organization (which was also established in 2006) and as a recognition of its
stroke campaign activities, the Stroke
Foundation of Bengal has won First Honorable Mention in the WSO World Stroke Day 2010
& 2012 awards. SFB has included
people from all walks of life in its campaign – a very positive aspect.
What have been the lows?
It is the apathy
of the many people, due to lack of stroke awareness - both general and
professional- which has hampered development of stroke care in India. The
priority of Stroke care is much less than Tuberculosis, AIDS and Malaria,
although stroke kills more people than all the other three do together, not to
talk of post stroke devastating disability.
Even among the NCDs , stroke gets minimum attention in
public health program. There is no government grants forthcoming smoothly.
There is no nationalized health insurance, there is no government initiated
rehabilitation facilities. prevention clinics which are of utmost importance in
developing countries. Government institutions offering comprehensive stroke
care are few in number and unavailable to the vast expanse of population. Of
concern is the apathy of the professional bodies and medical fraternity itself
towards prevention and rehabilitation of stroke care. SFB for that matter has
taken the leadership in the single
handed campaign with minimal help
whatsoever, and the results are promising.
What is your greatest hope for stroke survivors?
There is always
a ray of hope for stroke survivors. SFB has so far successfully spread stroke
education to most areas of eastern India and will continue its crusade. It has received great support from the
international stroke leaders and WSO. I am sure with such encouragement and
appropriate support , it is possible to
achieve the targeted goal of holistic affordable stroke care in approachable places.
By the influence of media and other modalities in program,
a section of people, mostly young
educated and rich have taken much
interests in this stroke devastation and extending all possible help to the
stroke survivors. The government has also shown some interests in stroke care
centres, although it will take some time to implement because of huge stroke
burden and paucity of funds.
What were the major elements of your stroke campaign?
Stroke
Foundation started its stroke prevention campaign since its inception in 2006.
The modalities adopted for the campaign are seminars, meetings, leaflets
distribution, articles in papers, magazines, Stroke Documentary (with English
subtitles) souvenir, etc., publication of quarterly stroke bulletin in both
Bengali and English and also regularly updated website (www.strokefoundationbengal.org)
and facebook. The activities of Stroke
Support Group (the second in India) for overall benefits of the stroke victims
and their family members are quite encouraging. Recently the Stroke Foundation has been able
to convince the persons in the Government and administration to set
up a stroke care service
centre in a remote underdeveloped
district with necessary financial help. The supports of the public, media and the
government are the major elements of the present stroke campaign
